Scene 2 Gunvor Dichmann Thyssen. Oplæg fra Sygeplejefestivalen 2014.

1. Tarmsvigtsenheden
Medicinsk Hepatologisk Gastroenterologisk Afdeling V
Patientinddragende omgivelser
- Fra outsider til insider
Sygeplejerske, stud.cand.cur Gunvor Dichmann Thyssen

2. Patientinddragende omgivelser
- Fra outsider til insider
Tarmsvigtsenheden
Medicinsk Hepatologisk Gastroenterologisk Afdeling V

3. Definition – intestinal failure
Inability to maintain protein-energi, fluid, electrolyte, or
micronutrient balance due to obstruction, dysmotility, surgical
resection, congenital defect, or disease-related loss of
absorption
O’Keefe S et al, clin Gastreoenterol hepatol 2006: 4: 6-10 Tarmsvigtsenheden
Medicinsk Hepatologisk Gastroenterologisk Afdeling V

4. Patientinddragende omgivelser
- Fra outsider til insider
Tarmsvigtsenheden
Medicinsk Hepatologisk Gastroenterologisk Afdeling V

5. Patientinddragende omgivelser
Inddragende rum og den inddragende patientstue
!
Patienternes oplevelse af omgivelserne i relation
til patientinddragelse
Tarmsvigtsenheden
Medicinsk Hepatologisk Gastroenterologisk Afdeling V

6. Patientinddragende rum
–Køkken
–Vaskerum
–Skyllerum
–Dagligstue
Tarmsvigtsenheden
Medicinsk Hepatologisk Gastroenterologisk Afdeling V

7. Patientinddragende rum
–Køkken
Tarmsvigtsenheden
Medicinsk Hepatologisk Gastroenterologisk Afdeling V

8. Patientinddragende rum
–Køkken
–Vaskerum
Tarmsvigtsenheden
Medicinsk Hepatologisk Gastroenterologisk Afdeling V

9. Patientinddragende rum
–Køkken
–Vaskerum
–Skyllerum
Tarmsvigtsenheden
Medicinsk Hepatologisk Gastroenterologisk Afdeling V

10. Patientinddragende rum
–Køkken
–Vaskerum
–Skyllerum
–Dagligstue
Tarmsvigtsenheden
Medicinsk Hepatologisk Gastroenterologisk Afdeling V

11. Den patientinddragende stue
- Patientens bog
- Journal
- Medicinskuffe
- Tavler
Tarmsvigtsenheden
Medicinsk Hepatologisk Gastroenterologisk Afdeling V

12. Patientinddragende rum
Tarmsvigtsenheden
Medicinsk Hepatologisk Gastroenterologisk Afdeling V
- Patientens bog
- Journal

13. Patientinddragende rum
Tarmsvigtsenheden
Medicinsk Hepatologisk Gastroenterologisk Afdeling V
- Patientens bog
- Journal
- Medicinskuffe

14. Patientinddragende rum
Tarmsvigtsenheden
Medicinsk Hepatologisk Gastroenterologisk Afdeling V
- Patientens bog
- Journal
- Medicinskuffe
- Tavler

15. Patient Preference and Adherence Dovepress
open access to scientific and medical research
Stor interesse for patientinddragelse
Patient: Passiv modtager ! aktiv deltager
Systematisk litteratursøgning !
–Manglende viden om IF-patienter og patientinddragelse
–Manglende viden om patientinddragelse i forhold til
omgivelserne
ORI G INA L R E S E ARCH
Open Access Full Text Article
How patients experience the surroundings
in relation to patient participation: a qualitative
study of inpatients with intestinal failure
Gunvor Dichmann Thyssen
Anne Beck
Department of Hepatology and
Gastroenterology, Aarhus University
Hospital, Aarhus, Denmark
Introduction: Patient participation is known to improve patients’ motivation, compliance,
treatment results, and satisfaction with the received care. It is well known that the physical
environment is of great importance in supporting patient involvement. A systematic literature
search has shown a lack of articles on the subject of “surroundings” in relation to patient par-ticipation,
for all patient groups.
Aim: We aimed to investigate how patients with intestinal failure experience their hospital
surroundings in relation to patient participation.
Methods: The study included eight patients admitted for at least 2 weeks at the Intestinal
Failure Unit, H8, Salford Royal NHS Foundation Trust, Manchester, United Kingdom. Included
patients had a good level of consciousness with no confusion. The included patients participated
in a semistructured interview. The interviews were analyzed using Malterud’s principles of
systematic text condensation.
Results: The patients described that the surroundings enabled them to participate in their treat-ment
and care. The surroundings made it possible for them and encouraged them to participate
through: the possibility to seek and get information and the possibility to participate in daily
activities. This led to a feeling of independence, reassurance, normality, control, responsibility,
and confidence.
Conclusion: The findings in this study indicate that the hospital surroundings are essential for
the patients with respect to their ability to participate in their own care and treatment. The sur-roundings,
in relation to patient participation, should be considered when planning and organizing
nursing care. Further research is needed to increase the understanding of the surroundings in
relation to patient participation
this research could, for eg, include the nurse’s perspective.
Keyword: patient perspective, patient involvement, patient environment, emotional consequences
Tarmsvigtsenheden
Medicinsk Hepatologisk Gastroenterologisk Afdeling V

16. Patient Preference and Adherence Dovepress
open access to scientific and medical research
ORI G INA L R E S E ARCH
Open Access Full Text Article
How patients experience the surroundings
in relation to patient participation: a qualitative
study of inpatients with intestinal failure
Kvalitativt studie
Informanter: otte indlagte patienter (plus et testinterview)
Interviewmetode: Semistruktureret interview
Analysemetode: Maleruds tekstkondenseringsprincip
Gunvor Dichmann Thyssen
Anne Beck
Department of Hepatology and
Gastroenterology, Aarhus University
Hospital, Aarhus, Denmark
Introduction: Patient participation is known to improve patients’ motivation, compliance,
treatment results, and satisfaction with the received care. It is well known that the physical
environment is of great importance in supporting patient involvement. A systematic literature
search has shown a lack of articles on the subject of “surroundings” in relation to patient par-ticipation,
for all patient groups.
Aim: We aimed to investigate how patients with intestinal failure experience their hospital
surroundings in relation to patient participation.
Methods: The study included eight patients admitted for at least 2 weeks at the Intestinal
Failure Unit, H8, Salford Royal NHS Foundation Trust, Manchester, United Kingdom. Included
patients had a good level of consciousness with no confusion. The included patients participated
in a semistructured interview. The interviews were analyzed using Malterud’s principles of
systematic text condensation.
Results: The patients described that the surroundings enabled them to participate in their treat-ment
and care. The surroundings made it possible for them and encouraged them to participate
through: the possibility to seek and get information and the possibility to participate in daily
activities. This led to a feeling of independence, reassurance, normality, control, responsibility,
and confidence.
Conclusion: The findings in this study indicate that the hospital surroundings are essential for
the patients with respect to their ability to participate in their own care and treatment. The sur-roundings,
in relation to patient participation, should be considered when planning and organizing
nursing care. Further research is needed to increase the understanding of the surroundings in
relation to patient participation
this research could, for eg, include the nurse’s perspective.
Keyword: patient perspective, patient involvement, patient environment, emotional consequences
Tarmsvigtsenheden
Medicinsk Hepatologisk Gastroenterologisk Afdeling V

17. Patient Preference and Adherence Dovepress
open access to scientific and medical research
ORI G INA L R E S E ARCH
Open Access Full Text Article
How patients experience the surroundings
in relation to patient participation: a qualitative
study of inpatients with intestinal failure
Gunvor Dichmann Thyssen
Anne Beck
Department of Hepatology and
Gastroenterology, Aarhus University
Hospital, Aarhus, Denmark
Introduction: Patient participation is known to improve patients’ motivation, compliance,
treatment results, and satisfaction with the received care. It is well known that the physical
environment is of great importance in supporting patient involvement. A systematic literature
search has shown a lack of articles on the subject of “surroundings” in relation to patient par-ticipation,
for all patient groups.
Aim: We aimed to investigate how patients with intestinal failure experience their hospital
surroundings in relation to patient participation.
Methods: The study included eight patients admitted for at least 2 weeks at the Intestinal
Failure Unit, H8, Salford Royal NHS Foundation Trust, Manchester, United Kingdom. Included
patients had a good level of consciousness with no confusion. The included patients participated
in a semistructured interview. The interviews were analyzed using Malterud’s principles of
systematic text condensation.
Results: The patients described that the surroundings enabled them to participate in their treat-ment
and care. The surroundings made it possible for them and encouraged them to participate
through: the possibility to seek and get information and the possibility to participate in daily
activities. This led to a feeling of independence, reassurance, normality, control, responsibility,
and confidence.
Conclusion: The findings in this study indicate that the hospital surroundings are essential for
the patients with respect to their ability to participate in their own care and treatment. The sur-roundings,
Patient Preference and Adherence 2014:8 submit your manuscript | www.dovepress.com
in relation to patient participation, should be considered when planning and organizing
nursing care. Further research is needed to increase the understanding of the surroundings in
relation to patient participation
this research could, for eg, include the nurse’s perspective.
Keyword: patient perspective, patient involvement, patient environment, emotional consequences
587
Tarmsvigtsenheden
Dovepress
Medicinsk Hepatologisk Gastroenterologisk Afdeling V
These statements, descriptions, and opinions were selected
to describe the surroundings as a phenomenon and the
extent to which it was important to the patients in relation
to patient participation. Furthermore, the investigators paid
special attention to the aspects of surroundings in relation
to patient participation that were repeated throughout the
different interviews.
The investigators collaborated throughout the whole
analysis process and completed all steps together.
activity room, the day room, and we encourage you to go
and take part in things and get involved.”
When talking about the surroundings, space was men-tioned
as being important in relation to participation. By
having ample space to move around and thereby, being able
to carry out daily activities, increased participation:
But just having the space to move around and make your
bed and sit and … that makes a huge difference.
Table 2 Analysis process
Temporary theme Meaning unit Artificial quote Final theme/subtheme
Peace of mind, reassurance,
independence, to be able to
“You just know that it is there [the
medicine]. So, you do not get that
anxious feeling when you are waiting
to get your tablets from the nurses”
The patients explained that the fact that
they had a medicine cabinet next to their
bed and that they had the opportunity to
self-medicate reduced their anxiousness
Reassurance

18. Tarmsvigtsenheden
Medicinsk Hepatologisk Gastroenterologisk Afdeling V

19. Emotional experiences
Confidence
”… and I thought: ”Well, I am quite capable of doing this” and it was a
test for me, how did I cope making my own bed, and I know now if I
go home, I am quite confident I can do that..”
Tarmsvigtsenheden
Medicinsk Hepatologisk Gastroenterologisk Afdeling V

20. Emotional experiences
Control
”You could see exactly what you have got to come, you could plan
your days because they try to balance it…. That I knew exactly what
I was having when and where, and times and that… and that
really… it is just knowing… It is back to being in control… You are
not really in control, but you have that illusion of being in control,
because you know what is happening…”
Tarmsvigtsenheden
Medicinsk Hepatologisk Gastroenterologisk Afdeling V

21. Emotional experiences
Reassurance
”You just know that they are there (the medicine red.). So, you
have not got that anxious feeling when you are waiting for your
tablets of the nurses.”
!
”It makes me feel happy that I can get it done (the laundry red.).
Not anxious that it is going to be lying around smelling, you
know… Makes me feel a lot more relaxed.”
Tarmsvigtsenheden
Medicinsk Hepatologisk Gastroenterologisk Afdeling V

22. Konklusion
Omgivelserne kan fremme evnen til at deltage i egen pleje og behandling
Fokus på omgivelser i relation til patientinddragelse
Fremtidig forskning
Tarmsvigtsenheden
Medicinsk Hepatologisk Gastroenterologisk Afdeling V